2型糖尿病周围神经病变患者血清同型半胱氨酸水平与神经传导速度、炎症介质及自由基生成的相关性

Correlation between Serum Homocysteine Levels, Nerve Conduction Velocity, Inflammatory Mediators and Free Radical Production in Patients with Type 2 Diabetic Peripheral Neuropathy

目的探讨2型糖尿病周围神经病变(DPN)患者血清同型半胱氨酸(Hcy)水平与神经传导速度、炎症介质及自由基生成的相关性。方法选取2017年3月至2020年3月于辽宁省人民医院内分泌科首次确诊为2型糖尿病患者108例作为研究对象,参照DPN诊断标准将其分为合并周围神经病变的DPN组和不合并周围神经病变的对照组。检测两组血清Hcy、炎症介质、自由基生成指标水平以及四肢感觉神经传导速度(SCV)。结果DPN组患者血清Hcy、白细胞介素-1β(IL-1β)、白细胞介素-17(IL-17)、高迁移率族蛋白B1(HMGB1)、可溶性细胞间黏附分子-1(sICAM-1)、糖基化终末产物(AGEs)、丙二醛(MDA)水平明显高于对照组,正中神经、尺神经、桡神经、腓总神经、胫神经的SCV以及血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平明显低于对照组;DPN组患者血清Hcy水平与正中神经、尺神经、桡神经、腓总神经、胫神经的SCV以及血清SOD、GSH-Px水平成负相关,与血清IL-1β、IL-17、HMGB1、sICAM-1、AGEs、MDA水平成正相关。结论DPN患者体内Hcy生成增多,与神经传导速度减退、炎症及氧化应激反应激活有关。

Objective To explore the relationship between serum homocysteine(Hcy) levels and nerve conduction velocity, inflammatory mediators and free radical production in patients with type 2 diabetic peripheral neuropathy(DPN). Methods A total of 108 patients with type 2 diabetes admitted to Department of Endocrinology, Liaoning Provincial People’s Hospital Endocrinology from March 2017 to March 2020 were selected as the research objects and were divided into a DPN group with DPN and a control group without DPN. The contents of Hcy, inflammatory cytokines, free radical production in serum and the levels of sensory nerve conduction velocity(SCV) were measured. Results The levels of serum Hcy, interleukin-1β(IL-1β), interleukin-17(IL-17), high mobility group protein B1(HMGB1), soluble intercellular adhesion molecule 1(sICAM1) and glycation end products(AGEs), malondialdehyde(MDA) in patients of DPN group were significantly higher than those in control group, the SCV levels of median nerve, ulnar nerve, radial nerve, common peroneal nerve, tibial nerve and the contents of superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) in serum were significantly lower than those of control group. The serum Hcy contents of DPN group were negatively correlated with the SCV levels of median nerve, ulnar nerve, radial nerve, common peroneal nerve, tibial nerve and the contents of SOD, GSH-Px, positively correlated with the contents of IL-1β, IL-17, HMGB1, sICAM1, AGEs and MDA in serum. Conclusion The increased production of Hcy in DPN patients correlates with decreased nerve conduction velocity, activation of inflammation and oxidative stress.